Jacob Andrade (NPI# 1659630044, PAC ID# 1951679059) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is RADIATION ONCOLOGY.
| Nation Provider ID (NPI) | 1659630044 |
| PAC ID by PECOS | 1951679059 |
| Professional Enrollment ID | I20180806001536 |
| Full Name | Jacob Andrade |
| Organization Legal Name | COASTAL RADIATION ONCOLOGY MEDICAL GROUP, INC. |
| Address |
1240 Westlake Blvd 103 Westlake Radiation Oncology Medical Westlake Village CA 91361-1929 |
| Phone Number | 8054944483 |
| Gender | M |
| Medical School | UNIVERSITY OF SOUTHERN CALIFORNIA SCHOOL OF MEDICINE |
| Graduation Year | 2012 |
| Primary Specialty | RADIATION ONCOLOGY |
| Group Practice PAC ID | 7214946201 |
| Number of Group Practice Members | 14 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050334 | SALINAS VALLEY MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1069 Los Palos Dr, Salinas, CA 93901-3916 | 8317582724 | COASTAL RADIATION ONCOLOGY MEDICAL GROUP, INC. |
| 2900 Loma Vista Rd, Suite 100, Ventura, CA 93003-2909 | 8056485191 | COASTAL RADIATION ONCOLOGY MEDICAL GROUP, INC. |
| 1240 Westlake Blvd, 103 Westlake Radiation Oncology Medical, Westlake Village, CA 91361-1929 | 8054944483 | COASTAL RADIATION ONCOLOGY MEDICAL GROUP, INC. |
| Organization Legal Name | COASTAL RADIATION ONCOLOGY MEDICAL GROUP, INC. |
| Physicians | 16 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Steven Lau | Radiation Oncology | Coastal Radiation Oncology Medical Group, Inc. | 1240 Westlake Blvd, 103 Westlake Radiation Oncology Medical, Westlake Village, CA 91361-1929 |
| Patrick A Williams | Radiation Oncology | Coastal Radiation Oncology Medical Group, Inc. | 1213 E Ocean Ave, Suite 100, Lompoc, CA 93436-7047 |
| Thomas D Fogel | Radiation Oncology | Coastal Radiation Oncology Medical Group, Inc. | 274 Heather Ct, Templeton, CA 93465-9738 |
| Paul J Miller | Radiation Oncology | Coastal Radiation Oncology Medical Group, Inc. | 2985 N Sycamore Dr, Simi Valley Radiation Oncology Medi, Simi Valley, CA 93065-1201 |
| Case H Ketting | Diagnostic Radiology | Coastal Radiation Oncology Medical Group, Inc. | 100 Casa St C, San Luis Obispo, CA 93405-8804 |
| Jeffrey K Wu | Radiation Oncology | Coastal Radiation Oncology Medical Group, Inc. | 100 Casa St C, San Luis Obispo, CA 93405-8804 |
| Robert R Johnson | Radiation Oncology | Coastal Radiation Oncology Medical Group, Inc. | 100 Casa St C, San Luis Obispo, CA 93405-8804 |
| Jonathan A Abelson | Radiation Oncology | Coastal Radiation Oncology Medical Group, Inc. | 100 Casa St C, San Luis Obispo, CA 93405-8804 |
| Jonathan R Stella | Radiation Oncology | Coastal Radiation Oncology Medical Group, Inc. | 100 Casa St C, San Luis Obispo, CA 93405-8804 |
| Kenneth J Biehl | Radiation Oncology | Coastal Radiation Oncology Medical Group, Inc. | 2230 Lynn Rd, Suite 103, Thousand Oaks, CA 91360-1963 |
| Street Address |
1240 WESTLAKE BLVD 103 WESTLAKE RADIATION ONCOLOGY MEDICAL |
| City | WESTLAKE VILLAGE |
| State | CA |
| Zip | 91361-1929 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Steven Lau | Radiation Oncology | Coastal Radiation Oncology Medical Group, Inc. | 1240 Westlake Blvd, 103 Westlake Radiation Oncology Medical, Westlake Village, CA 91361-1929 |
| Irwin Hoffman | Psychologist, Clinical | 1240 Westlake Blvd, Suite 211, Westlake Village, CA 91361-1993 | |
| Andrew J Mikaelian | Otolaryngology | 1240 Westlake Blvd, Suite 135, Westlake Village, CA 91361-1987 | |
| Eugene S Ahn | Radiation Oncology | Coastal Radiation Oncology Medical Group, Inc. | 1240 Westlake Blvd, 103 Westlake Radiation Oncology Medical, Westlake Village, CA 91361-1929 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Pezhman Nazemi | Ophthalmology | 351 E Rollings Oaks Dr, Suite 201, Thousand Oaks, CA 91361 | |
| Irina Feldman | Family Medicine | 375 Rolling Oaks Dr, Suite 115, Thousand Oaks, CA 91361-1000 | |
| Christine E Dahlin | Internal Medicine | 375 Rolling Oaks Dr, Suite 115, Thousand Oaks, CA 91361-1000 | |
| Kelley Ann Bannon | Qualified Audiologist | Decibel Hearing Services | 375 Rolling Oaks Dr, Suite 140, Thousand Oaks, CA 91361-1001 |
| Kenneth A Raven | Psychologist, Clinical | 25 W Rolling Oaks Dr, Suite 107, Thousand Oaks, CA 91361-1003 | |
| Steven Hershel Suchman | Family Medicine | 77 Rolling Oaks Dr, Suite 305, Thousand Oaks, CA 91361-1007 | |
| Barbara L Irish | Physician Assistant | Hullander and Mozingo Lp | 339 S Moorpark Rd, Thousand Oaks, CA 91361-1008 |
| Martin M Mortazavi | Neurosurgery | California Brain Institute Inc | 333 S Moorpark Rd, Thousand Oaks, CA 91361-1008 |
| Nicholas Fettman | Otolaryngology | West Coast Ear, Nose and Throat | 302 S Moorpark Rd, Thousand Oaks, CA 91361-1008 |
| David Rosenfeld | Colorectal Surgery (proctology) | David B. Rosenfeld Md Inc | 341 S Moorpark Rd, T.o.p., Thousand Oaks, CA 91361-1008 |
| Find all physicians in zip 91361 | |||
| City | WESTLAKE VILLAGE |
| Zip Code | 91361 |
| Specialty | RADIATION ONCOLOGY |
| City + Specialty | WESTLAKE VILLAGE + RADIATION ONCOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.